Staphylococcus aureus bacteremia - Revision history

Aidan: /* Etiology */

2024-09-27T12:43:23Z

Etiology

← Older revision		Revision as of 12:43, 27 September 2024
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	===Etiology===		===Etiology===

			*[[Skin and soft tissue infection]], including infections of a [[decubitus ulcer]] in hospitalized patients
	*IVDU
			*[[Infective endocarditis]]
			*[[Osteomyelitis]]
			*[[Septic arthritis]]
			*[[Septic thrombophlebitis]]
			*[[Central line-associated bloodstream infection]]
			*Injection drug use
	*Poor dentition		*Poor dentition
	*Dental work		*Dental work

Aidan: added specific doses for IV and oral therapy

2024-04-04T16:45:44Z

added specific doses for IV and oral therapy

Show changes

Aidan at 14:05, 2 May 2022

2022-05-02T14:05:21Z

@@ Line 16: / Line 16: @@
 *May have back pain unrelated to spinal osteomyelitis
 *May present with focus of metastatic disease
 *Associated with about 30% mortality[[CiteRef::bai2022st]]
 ==Investigations==
@@ Line 39: / Line 51: @@
 *Infectious diseases consultation
 **Low risk for endocarditis (no TEE) if all of the following:
 ***No intracardiac device
@@ Line 54: / Line 68: @@
 ***No evidence of metastases
 ***+/- identified source has been removed
 *MSSA: [[cloxacillin]] 2g IV q4h for 2 weeks ([[cefazolin]] as an alternative)
 *MRSA: [[vancomycin]] 1g IV q12h for 2 weeks
 **Adjust based on serum trough before every fourth dose
 **Target trough 15-20
 ==Further Reading==

Aidan at 14:02, 2 May 2022

2022-05-02T14:02:42Z

← Older revision		Revision as of 14:02, 2 May 2022
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	***Persistent bacteremia beyond 72 hours		***Persistent bacteremia beyond 72 hours
	**Can also use [[VIRSTA score]] to decide if they need TEE[[CiteRef::tubiana2016th]]		**Can also use [[VIRSTA score]] to decide if they need TEE[[CiteRef::tubiana2016th]]
			***Highest sensitivity (~99%), though specificity only 35%
⚫	***~~Preferred~~ to others like the [[PREDICT score]][[CiteRef::van der vaart2021pr]]
			***The high sensitivity gives very high negative predictive value of ~99%
		⚫	***Likely preferred to others like the [[PREDICT score]], which has lower sensitivity though higher specificity[[CiteRef::van der vaart2021pr]]

	==Management==		==Management==

Aidan at 13:59, 2 May 2022

2022-05-02T13:59:56Z

← Older revision		Revision as of 13:59, 2 May 2022
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	***Injection drug use		***Injection drug use
	***Persistent bacteremia beyond 72 hours		***Persistent bacteremia beyond 72 hours
	**Can also use [[PREDICT score]] to decide if they need TEE[[CiteRef::palraj2015pr]]
	**Can also use [[VIRSTA score]] to decide if they need TEE[[CiteRef::tubiana2016th]]		**Can also use [[VIRSTA score]] to decide if they need TEE[[CiteRef::tubiana2016th]]
			***Preferred to others like the [[PREDICT score]][[CiteRef::van der vaart2021pr]]

	==Management==		==Management==

Aidan at 15:04, 15 April 2022

2022-04-15T15:04:02Z

← Older revision		Revision as of 15:04, 15 April 2022
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	*May have back pain unrelated to spinal osteomyelitis		*May have back pain unrelated to spinal osteomyelitis
	*May present with focus of metastatic disease		*May present with focus of metastatic disease
			*Associated with about 30% mortality[[CiteRef::bai2022st]]

	==Investigations==		==Investigations==
Line 30:		Line 31:
	***Injection drug use		***Injection drug use
	***Persistent bacteremia beyond 72 hours		***Persistent bacteremia beyond 72 hours
	**Can also use [[PREDICT score]] to decide if they need TEE		**Can also use [[PREDICT score]] to decide if they need TEE[[CiteRef::palraj2015pr]]
			**Can also use [[VIRSTA score]] to decide if they need TEE[[CiteRef::tubiana2016th]]

	==Management==		==Management==

Aidan at 01:58, 29 August 2021

2021-08-29T01:58:11Z

← Older revision		Revision as of 01:58, 29 August 2021
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	{{DISPLAYTITLE:''Staphylococcus aureus'' bacteremia}}		{{DISPLAYTITLE:''Staphylococcus aureus'' bacteremia}}
	[[Category:Endovascular infections]]		[[Category:Endovascular infections]]
			[[Category:Bacteremias]]

Aidan: /* Management */

2021-02-06T13:47:34Z

Management

← Older revision		Revision as of 13:47, 6 February 2021
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	***Sterile follow-up blood cultures within 4 days from the initial set		***Sterile follow-up blood cultures within 4 days from the initial set
	***No hemodialysis		***No hemodialysis
	***Nosocomial acquisition ~~of [[S. aureus]]~~		***Nosocomial acquisition
	***Absence of secondary foci		***Absence of secondary foci
	***No clinical signs of endocarditis		***No clinical signs of endocarditis

Aidan: /* Management */

2021-02-06T13:47:24Z

Management

← Older revision		Revision as of 13:47, 6 February 2021
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	*Infectious diseases consultation		*Infectious diseases consultation
	*Must rule out endocarditis! TTE, followed by TEE if suspicion remains high		*Must rule out endocarditis! TTE, followed by TEE if suspicion remains high (see [[PREDICT score]])
	*Low risk for endocarditis (no TEE) if all of the following:		**Low risk for endocarditis (no TEE) if all of the following:
	**No intracardiac device		***No intracardiac device
	**Sterile follow-up blood cultures within 4 days from the initial set		***Sterile follow-up blood cultures within 4 days from the initial set
	**No hemodialysis		***No hemodialysis
	**Nosocomial acquisition of [[S. aureus]]		***Nosocomial acquisition of [[S. aureus]]
	**Absence of secondary foci		***Absence of secondary foci
	**No clinical signs of endocarditis		***No clinical signs of endocarditis
	*Uncomplicated if:		**Uncomplicated if all of the following:
	**Endocarditis is excluded		***Endocarditis is excluded
	**No implanted prostheses		***No implanted prostheses
	**Blood cultures clear by 2-4 days		***Blood cultures clear by 2-4 days
	**Defervesces within 72 hours		***Defervesces within 72 hours
	**No evidence of metastases		***No evidence of metastases
	**+/- identified source has been removed		***+/- identified source has been removed
	*Two-week course acceptable if uncomplicated, otherwise 4-6 weeks		*Two-week course acceptable if uncomplicated, otherwise 4-6 weeks
	*MSSA: [[cloxacillin]] 2g IV q4h for 2 weeks ([[cefazolin]] as an alternative)		*MSSA: [[cloxacillin]] 2g IV q4h for 2 weeks ([[cefazolin]] as an alternative)

Aidan: /* Management */

2021-02-06T13:36:59Z

Management

← Older revision		Revision as of 13:36, 6 February 2021
Line 30:		Line 30:
	***Injection drug use		***Injection drug use
	***Persistent bacteremia beyond 72 hours		***Persistent bacteremia beyond 72 hours
			**Can also use [[PREDICT score]] to decide if they need TEE

	==Management==		==Management==
Line 42:		Line 43:
	**Absence of secondary foci		**Absence of secondary foci
	**No clinical signs of endocarditis		**No clinical signs of endocarditis
	*Uncomplicated if		*Uncomplicated if:
	**Endocarditis is excluded		**Endocarditis is excluded
	**No implanted prostheses		**No implanted prostheses